Ops face axe to cut NHS costs

8:55am Friday 16th February 2007

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Patients waiting for a range of routine operations could find their surgery axed to help the NHS save money.

Oxfordshire NHS Primary Care Trust managers are looking at five treatments to decide whether to cut the number of operations they commission.

A similar review in 2005 saw hernia, cardiac ablations and varicose vein patients removed from waiting lists.

This time, the PCT is reviewing hysterectomies, where women have their wombs removed, and dilatation and curettage, where part of the womb lining is removed, along with lower back surgery, tonsillectomy, to remove the tonsils, and myringotomy, where an incision is made in the ear drum to drain fluid. The latter two operations are mainly done on children.

The PCT wants to save £18m this financial year and keep a tight rein on spending next year.

In a board report last December, Matthew Tait, the director of finance and performance, said they had managed to halve the amount of hernia operations. He added: "We're looking at five further areas. Although these are unlikely to result in cost reduction this year, they will form part of our recovery plan next year."

When contacted by the Oxford Mail, managers first tried to deny they were considering the move, before claiming the review was in line with Department of Health guidance - ministers say decisions on treatments are a PCT matter.

The PCT finally admitted it could not guarantee patients already referred for one of the five treatments would stay on the waiting list, if it was decided to make the cuts.

Oxford West and Abingdon MP Dr Evan Harris, who raised the issue in the House of Commons, said that although many operations might not be clinically essential, they made a difference to patients.

He added: "I'm concerned that when the Oxford Mail approached the PCT initially, they denied they were doing anything. Only on further questioning have they admitted that this is on the agenda.

"If they're going to do this, they must be transparent about it."

Dr Ljuba Stirzaker, PCT public health medicine consultant and chairman of the Oxfordshire Priorities Forum, which decides which treatments should be used within the county, said: "We understand that the DoH wants us to look at these five, because some patients may be operated on unnecessarily.

"It has been suggested that we look at these procedures to save money. I honestly don't know how much money it could save us."

The PCT has issued guidelines to GPs not to prescribe more than 28 days' medication at a time in a bid to cut wastage of drugs.

Doctors say the move is inconvenient and will be expensive for patients who rely on long-term medication and will have to pay a fee for each new prescription.

Dr Stirzaker said GPs could still use their judgment on individual cases.